JP2019524355A - Articulated meniscus repair device - Google Patents

Abstract

The meniscal repair device includes an articulation mechanism configured to move the needle on the tip in a controlled arc. Multiple directions of motion are provided to facilitate placement of the suture anchor. In one aspect, the articulation mechanism includes a series of movable members that are coupled together by two wires that are provided with a push / pull force via a control mechanism. [Selection] Figure 2-1

Description

  In order to reach the meniscus of the knee, existing art meniscal repair devices in the art utilize a rigid needle tip that is fixed, for example, having a straight or curved profile. However, due to the juxtaposition of the components within the knee structure, these fixed size repair devices do not have easy access to the meniscal tear located over the entire meniscus region.

  There is a need for a repair device that can access the entire area of the meniscus to facilitate repair.

  In one aspect, the meniscal repair device is coupled to a flexible shaft, an articulation mechanism disposed about the flexible shaft, and an articulation mechanism configured to move the articulation mechanism through a controlled arcuate motion. Control mechanism.

  The articulation mechanism may include a plurality of movable members disposed about the flexible shaft and coupled in series with each other.

  The articulation mechanism may comprise a joint tube disposed around the flexible shaft and may include two flexible bands extending parallel to each other through the joint tube.

  Various aspects of at least one embodiment of the present disclosure are discussed below with reference to the accompanying drawings. It will be appreciated that for simplicity and clarity of illustration, elements shown in the drawings have not necessarily been drawn to scale accurately or correctly. For example, the dimensions of some elements may be exaggerated relative to other elements for clarity, or several physical components may be included in one functional block or element. Further, where considered appropriate, reference numerals may be repeated among the drawings to indicate corresponding or analogous elements. For clarity, not all components can be labeled in all drawings. The drawings are provided for purposes of illustration and description, and are not intended to define the limits of the invention.

1 and 1A show a known meniscal repair device. FIG. 2-1 is a perspective view of a meniscal repair device according to one aspect of the present disclosure. FIG. 2-2 is a perspective view of a meniscal repair device according to one aspect of the present disclosure. FIGS. 3-1 and 3-2 are enlarged views of the circled portions shown in FIGS. 2-1 and 2-2, respectively. FIG. 4-1 shows a flexible portion of a meniscal device according to one embodiment of the present disclosure. FIG. 4-2 shows a flexible portion of a meniscal device according to one embodiment of the present disclosure. FIG. 5 is a cross-sectional view of the flexible portion shown in FIGS. 4-1 and 4-2. FIG. 6 is an exploded view of the flexible portion shown in FIGS. 4-1 and 4-2. FIG. 7 shows the link of the flexible part shown in FIGS. 4-1 and 4-2. FIG. 8 is an exploded view of a control mechanism according to aspects of the present disclosure. FIG. 9 is an enlarged view of the control mechanism of FIG. 10 is a cross-sectional view of the control mechanism of FIG. 8 of the repair device. FIG. 11A is a perspective view of a thumb wheel portion of the control mechanism of FIG. 11-2 is a perspective view of a thumb wheel portion of the control mechanism of FIG. FIG. 12 is a perspective view of a meniscal repair device according to another aspect of the present disclosure. FIG. 13 is an enlarged view of the flexible portion of the repair device of FIG. FIG. 14A is an exploded view of the flexible portion shown in FIG. 13. 14-2 is an exploded view of the flexible portion shown in FIG. 14-3 is an exploded view of the flexible portion shown in FIG.

  In the following detailed description, numerous specific details are set forth in order to provide a thorough understanding of aspects of the present disclosure. Those skilled in the art will appreciate that these can be practiced without making some of these specific details independently. In other instances, well-known methods, procedures, components, and structures may not be described in detail so as not to obscure the embodiments.

  Before describing at least one aspect of the present disclosure in detail, it is understood that its application is not limited to the structural details and component arrangements set forth in the following description or illustrated in the drawings. Should. There are various ways to be implemented or performed. It should also be understood that the expressions and terms used herein are for illustrative purposes only and should not be considered limiting.

  For clarity, certain features are described in the context of separate embodiments, but it will be understood that they may be provided in combination in a single embodiment. Conversely, various features are described in the context of a single embodiment for the sake of brevity, but may be provided separately or in any suitable subcombination.

  In its broadest sense, aspects of the present disclosure are directed to a joint mechanism configured to operate a needle in a controlled arc on the tip of a meniscal repair device. Multiple directions of motion are provided to facilitate placement of the suture anchor. In one aspect, the articulation mechanism includes a series of movable members that are coupled together by two wires that are provided with a push / pull force via a control mechanism. This configuration allows these movable members to move relative to each other, as will be described in more detail below.

  Referring now to FIGS. 1 and 1A, a known meniscal repair device 100 utilizes a straight distal portion 104. A rigid needle tip 108 is located at the end of the distal portion 104 and provides a repair device 112. These rigid devices 100 cannot easily reach the entire meniscus area and may therefore be insufficient.

  According to one aspect of the present disclosure, as shown in FIGS. 2-1 and 2-2, the meniscal repair device 200 includes a handle 204, a control mechanism 208 coupled to the handle 204, and a control mechanism 208 coupled to the handle 204. A flexible actuator push rod 212 and a support tube 216 are included. The support tube 216 includes a flexible portion 220 and a needle tip 224 at the distal end of the support tube 216.

  The flexible portion 220 is defined around the support tube 216 as shown in each enlargement of the circled portions shown in FIGS. 2-1 and 2-2 of FIGS. Can be bent at the arc A. As described in more detail below, the flexible portion 220 includes a number of components and control wires coupled to the control mechanism 208 to facilitate deflection of the distal end of the device 200. .

  The flexible portion 220 includes a number of interconnected links 404 disposed between the parent link 408 and the end link 412 as shown in FIGS. 4-1 and 4-2. End link 412 is coupled to support tube 216, while parent link 408 is coupled to needle tip 224. Two wires 416 are threaded through the parent link 408, end link 412, and interstitial link 404 and are used to control the direction and amount of flexure bending.

  As shown in FIG. 5, the flexible shaft 504 extends through the link 404 and into the support tube 216. As the flexible portion 220 is bent, the flexible shaft 504 also bends. Further, the meniscal implant is shown as being placed on the needle tip 224 before being inserted for meniscal repair. The sutures normally attached to the meniscal implant device are not shown for clarity.

  As shown in the exploded view of the distal portion of the device in FIG. 6, there are two pairs of wires 416 that traverse the length of the support tube 216 and fold back to the control mechanism 208 through the parent link 408. The two wires 416 operate in a push / pull relationship by the operation of the control mechanism 208 to direct the needle tip 224 and thus for the placement of the repair device 112. The number of intermediate links 404 may be selected to provide a different amount of deflection or a desired radius.

  As shown in FIG. 7, each intermediate link 404 includes a plurality of wire conduits 704 through which wires 416 pass, in addition to link protrusions 708 on one surface and link receivers 712 on the opposite surface. . The link protrusion 708 of one link 404 is intended to couple with a corresponding link receiver 712 of an adjacent link 404 as shown. Parent link 408 incorporates link receiver 712 but does not require link protrusion 708 and correspondingly end link 412 includes link protrusion 712 but does not require link receiver 708.

  Referring now to FIG. 8, the control mechanism 208 is coupled to a wire 416 that is used to control the flexible portion 220 of the device 200. The control mechanism 208 is mounted between the right half 804-R and the left half 804-L of the handle portion 204 and includes a thumb wheel 904 and a wire cradle 908 as shown in FIG. The wire cradle 908 includes a plurality of openings 912 through which the wire 416 passes to provide the pushing / pulling force of the wire 416 necessary to move the flexible portion 220 of the device 200. Advantageously, the direction in which the thumbwheel 904 can be moved defines a plane in which the flexible portion 220 can be manipulated. Thus, the operator of the device 200 has a visual and tactile mechanism that identifies the plane in which the needle tip 224 of the device 200 operates, as can be seen in FIG. Further, the control mechanism can include a locking mechanism that holds the distal end at a particular angle. The locking mechanism can be a friction lock, a ratchet lock, a claw lock, or other technique.

  As shown in FIGS. 11A and 11B, the wire 416 passes through one of the openings 912 of the wire cradle 908 on one surface and passes to the other surface, and then the other of the openings 912. Return through and close the wire loop.

  When the tip reaches the desired position, the flexible actuator push rod 212 is used to push the repair device 112 into place. The flexible actuator push bar 212 may provide tactile feedback and position control to the user. The flexible portion 220 can be replaced to increase or decrease the tip stiffness.

  In an alternative aspect of the present disclosure, a flexible portion 1204 is provided at the distal end of the support tube 1208 intermediate to the needle tip 224, as shown in FIGS. The flexible portion 1204 includes an articulating tube 1212 such as a laser cut flexible tube made of plastic, for example. Two flexible bands 1216 are provided through the support tube 1208 and terminate at the head portion 1220 as shown. In operation, pulling one or the other of the bands 1216 causes the flexible portion 1204 to bend in that direction.

  Referring now to FIGS. 14-1 through 14-3, the articulation tube 1212 includes parallel band guides 1414 through which each band 1216 extends and terminates at a head portion 1220.

  The length of the articulation tube 1212 can be selected to determine the radius of curvature and placement, number and thickness of the cuts within the tube 1212.

  It should be understood that the detailed description of the embodiments of the present invention is provided by way of illustration only and is not intended to limit the scope of the present invention. Features and / or steps described with respect to one embodiment may be combined with other embodiments, and all embodiments of the invention are shown in a particular figure or described with respect to one of the embodiments. Does not have all of the features and / or processes. Variations of the described embodiments will occur to those skilled in the art.

  Although the present disclosure has been described herein with reference to specific materials and embodiments, the present disclosure is not limited to the specific ones disclosed herein; rather, the disclosure It extends to all functionally equivalent structures, methods and uses, such as within the scope of the appended claims.

Claims (25)

A meniscus repair device,
Flexible shaft,
An articulation mechanism disposed about the flexible shaft; and
A meniscal repair device comprising: a control mechanism coupled to the joint mechanism configured to move the joint mechanism through a controlled arcuate motion.   The meniscal repair device of claim 1, wherein the articulation mechanism comprises a plurality of movable members disposed about the flexible shaft and coupled in series with each other. The joint mechanism is
Further comprising two wires coupling the movable member to each other;
The meniscal repair device of claim 2, wherein the control mechanism is further configured to be coupled to the two wires and pull one of the two wires at a time.   The meniscal repair instrument of claim 3, wherein the control mechanism further comprises a thumbwheel coupled to the two wires.   The meniscal repair instrument of claim 3, wherein the control mechanism is further configured to push one wire and simultaneously pull the other wire. The joint mechanism is
4. The meniscal repair device of claim 3, further comprising a distal movable member terminating each of the two wires.   The meniscal repair device of claim 3, further comprising a retention mechanism coupled to the articulation mechanism configured to prevent the two wires from moving. A movable member support tube disposed about the flexible shaft and coupled to the articulation mechanism, the movable member tube including a first conduit and a second conduit;
4. The meniscal repair device of claim 3, wherein each of the two wires is respectively disposed within the first conduit and the second conduit.   The meniscal repair device of claim 8, wherein the first conduit and the second conduit are disposed at an angle of 180 degrees relative to each other around the circumference of the flexible shaft.   4. A meniscal repair device according to any of claims 2 or 3, wherein the coupling portions of one movable member are coupled in series to adjacent movable members.   11. The meniscal repair device of claim 10, wherein the coupling portion defines a plane to which the controlled arcuate motion belongs.   The meniscal repair instrument of claim 1, wherein the articulation mechanism includes a joint tube disposed about the flexible shaft. The joint mechanism is
The meniscal repair device of claim 12 further comprising two flexible bands extending parallel to each other through the articulation tube. A meniscus repair device,
A flexible shaft;
A support tube disposed around a portion of the flexible shaft;
A joint mechanism coupled to the movable member support tube,
An articulation mechanism including two wires and a plurality of movable members disposed around the flexible shaft and coupled in series by the two wires;
A floating wire cradle coupled to the two wires, the floating wire cradle configured to push one wire and simultaneously pull the other wire;
A flexible actuator disposed at a distal end of the flexible shaft;
A push rod disposed on the flexible shaft and the flexible actuator;
A meniscal repair device comprising: a needle portion disposed at a distal end of the flexible actuator to define a distal tip of the meniscal repair instrument.   The meniscal repair device of claim 14 further comprising a plurality of implants provided in the movable member support.   16. The meniscal repair device of claim 15, wherein a suture attached to the implant is housed within the movable member support tube. The joint mechanism is
The meniscal repair device of claim 14, further comprising a distal movable member terminating each of the two wires. A holding mechanism coupled to the joint mechanism,
18. A meniscal repair device according to any of claims 14 to 17 configured to prevent movement of two wires. The movable member support tube is
A first wire conduit and a second wire conduit;
19. A meniscal repair device according to any of claims 14-18, wherein each of the two wires is respectively disposed within the first conduit and the second conduit.   20. The meniscal repair device of claim 19, wherein the first wire conduit and the second wire conduit are disposed at an angle of 180 degrees relative to each other around the circumference of the flexible shaft.   21. A meniscal repair device according to any one of claims 14 to 20 wherein the coupling portions of one movable member are coupled in series to adjacent movable members.   The meniscal repair device of claim 21, wherein the coupling portion defines a plane in which the articulation mechanism operates.   23. A meniscal repair device according to any of claims 14-22, wherein a plurality of incisions are provided in the flexible shaft and are configured to facilitate a bending motion of the flexible shaft.   24. The meniscal repair device of any of claims 14 to 23, wherein the flexible shaft comprises plastic.   25. A meniscal repair device according to any of claims 14 to 24, wherein the wire cradle includes a thumbwheel.

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